![]() The main goal of treating respiratory failure is to ensure that sufficient oxygen reaches the lungs and is transported to the other organs while carbon dioxide is cleared from the body. In severe cases, signs and symptoms may include cyanosis (a bluish color of the skin, lips, and fingernails), confusion, and sleepiness. Signs and symptoms of respiratory failure include shortness of breath (dyspnea), rapid breathing (tachypnea), rapid heart rate (tachycardia), unusual sweating (diaphoresis), decreasing pulse oximetry readings below 90%, and air hunger (a feeling as if you can’t breathe in enough air). Untreated respiratory failure can lead to respiratory arrest. Acute respiratory failure requires emergency treatment. It is often caused by a disease or injury that affects breathing, such as pneumonia, opioid overdose, stroke, or a lung or spinal cord injury. Acute respiratory failure can happen quickly without much warning. Respiratory failure is a life-threatening condition that is caused when the respiratory system cannot get enough oxygen from the lungs into the blood to oxygenate the tissues, or there are high levels of carbon dioxide in the blood that the body cannot effectively eliminate via the lungs. Respiratory failure and respiratory arrest often require emergency suctioning. Respiratory Failure and Respiratory Arrest Tracheostomy care and suctioning are performed collaboratively by nurses and respiratory therapists. ![]() Tracheostomies require routine care to prevent infection and obstruction, as well as frequent suctioning to maintain a patent airway. A tracheostomy tube is a tube that is inserted through a surgical opening in the neck to the trachea to create an artificial airway. Tracheostomy suctioning uses a sterile catheter that is inserted through a tracheostomy tube into a patient’s trachea. Nasal and pharyngeal suctioning is performed with a sterile, soft, flexible catheter to remove accumulated saliva, pulmonary secretions, blood, vomitus, or other foreign material from nasopharyngeal areas that cannot be removed by the patient’s spontaneous cough or other less invasive procedures. During oral suctioning, a rigid plastic suction catheter is typically used in a patient’s mouth to remove oral secretions. The purpose of respiratory suctioning is to maintain a patent airway and improve oxygenation by removing mucous secretions and foreign material (e.g., vomit or gastric secretions). This chapter will discuss tracheostomy care and various types of suctioning (e.g., oral, nasal, pharyngeal, and tracheostomy) performed by nurses. Recognize and report significant deviations from norms
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